Related Experiment Video

Updated: Oct 3, 2026

Intrathecal Application of a Fluorescent Dye for the Identification of Cerebrospinal Fluid Leaks in Cochlear Malformation
06:59

Intrathecal Application of a Fluorescent Dye for the Identification of Cerebrospinal Fluid Leaks in Cochlear Malformation

Published on: February 29, 2020

Intrathecal amphotericin in the management of coccidioidal meningitis

D A Stevens1, S A Shatsky

  • 1Division of Infectious Diseases, Department of Medicine, Santa Clara Valley Medical Center, San Jose, CA 95128-2699, USA. oflaherty@hhs.co.santa-clara.ca.us

Seminars in Respiratory Infections
|December 12, 2001
PubMed

Insights

Coccidioidal meningitis requires effective treatment. Intra-cerebrospinal fluid (CSF) amphotericin offers rapid infection clearance but demands careful management due to toxicity, especially for unfamiliar clinicians.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Neurology

Background:

  • Coccidioidal meningitis is a life-threatening fungal infection of the brain and spinal cord.
  • Standard azole treatments for coccidioidal meningitis often fail to achieve a complete cure.
  • Intra-cerebrospinal fluid (CSF) amphotericin is considered for its potent antifungal activity but carries significant risks.

Purpose of the Study:

  • To share clinical experience in managing intra-CSF amphotericin therapy for coccidioidal meningitis.
  • To provide procedural details for medical and surgical management of this treatment approach.
  • To educate clinicians and trainees on optimizing treatment and mitigating toxicity.

Main Methods:

  • Retrospective review of cases treated with intra-CSF amphotericin.
  • Detailed description of medical management strategies, including dosing and monitoring.
  • Explanation of surgical procedures and techniques for CSF drug delivery.

Main Results:

  • Intra-CSF amphotericin can effectively clear coccidioidal meningitis infections.
  • Careful management is crucial to minimize severe toxicity associated with intra-CSF amphotericin.
  • Successful outcomes are achievable with experienced clinical oversight.

Conclusions:

  • Intra-CSF amphotericin remains a valuable, albeit complex, treatment option for refractory coccidioidal meningitis.
  • Standardized management protocols and physician training are essential for safe and effective intra-CSF amphotericin use.
  • Further research into less toxic, equally effective therapies is warranted.

Related Concept Videos

Cryptococcal Meningitis01:27

Cryptococcal Meningitis

Cryptococcal meningitis is a life-threatening opportunistic infection predominantly associated with HIV/AIDS, accounting for over 100,000 deaths annually worldwide. However, it also affects individuals with other forms of immunosuppression, including those undergoing immunosuppressive therapy, organ transplant recipients, patients with innate immunodeficiencies, and individuals with hematological disorders. The infection is caused mainly by Cryptococcus neoformans and Cryptococcus gattii,...
Antifungal Agents01:15

Antifungal Agents

Amphotericin B is a broad-spectrum antifungal agent that exploits structural differences between fungal and mammalian cell membranes. Its amphipathic structure—featuring a hydrophobic polyene-lactone ring and a hydrophilic region containing mycosamine and carboxylic acid groups—enables selective binding to ergosterol, a sterol predominantly found in fungal plasma membranes. This selective interaction underlies the drug’s antifungal activity, although weak binding to cholesterol contributes to...
Brain Abscess l: Introduction01:26

Brain Abscess l: Introduction

A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial infections,...
Bacterial Meningitis01:24

Bacterial Meningitis

Bacterial meningitis is a severe infectious disease involving inflammation of the meninges, the protective membranes surrounding the brain and spinal cord. It occurs when pathogenic bacteria cross the blood–brain barrier and enter the cerebrospinal fluid. Common causative organisms include Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae type b, Listeria monocytogenes, and Escherichia coli K1. The exact route of entry varies by pathogen and host condition.Routes of Entry...